Organization Active NPI

Brajesh Bhatla MD PA

  • Nephrology Physician
  • Harlingen, TX
National Provider Identifier
1821044108
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
BRAJESH BHATLA MD PA
Practice address
4402 E Sesame Dr
Harlingen, TX 78550-9290
Phone
(956) 412-1125
Fax
(956) 440-8854
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brajesh Bhatla, M.D.NPI 1821045600
Title
Physician
Phone
(956) 412-1125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X TX Primary

Addresses

Primary practice location

4402 E Sesame Dr
Harlingen, TX 78550-9290

Mailing address

PO Box 2835
Harlingen, TX 78551-2835
Phone (956) 412-1125

Other identifiers 2

IdentifierTypeStateIssuer
0031LWOtherTXBC/BS
166456701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803000587 TX Part B Supplier - Clinic/Group Practice 7810968997 Receives reassigned benefits from 2 practitioners
Practice locations: Harlingen, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0984156Brajesh Bhatla MD PA4402 Sesame Drive, Harlingen, TX 78550Certificate of waiverMar 14, 2027

National Provider Directory

National Provider Directory

Locations

4402 E Sesame Dr
Harlingen, TX 78550
Phone (956) 412-1125

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1821044108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2835",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785512835",
            "telephone_number": "956-412-1125",
            "fax_number": "956-440-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 E SESAME DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785509290",
            "telephone_number": "956-412-1125",
            "fax_number": "956-440-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAJESH BHATLA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BHATLA",
        "authorized_official_first_name": "BRAJESH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "956-412-1125",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0031LW",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166456701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.